Abstract
The Korea Central Cancer Registry conducted the National Epidemiologic Survey of Thyroid cancer (NEST) to investigate changes in the epidemiological and clinical characteristics of thyroid cancer patients between 1999 and 2008. The NEST was designed to collect representative samples of patients with thyroid cancer diagnosed in the years 1999, 2005, and 2008 using a proportionally stratified and systematic random sampling method. Among 42,891 participants diagnosed with thyroid cancer, 5,796 participants were included in the final study population. This survey collected information on diagnostic methods and date, route of diagnosis, prior medical history and history of thyroid-related disease, tumor, lymph node, metastasis and collaborative stage, and treatment. The NEST dataset was also linked to the cause-of-death database from Statistics Korea. The mean age of the study participants was 46.9 years. The ratio of men to women was 1:5.5. In the analysis of the histologic type of cancer, the proportion of papillary thyroid carcinoma showed an increasing trend (p<0.01). In contrast, the proportion of distant metastasis and the mean tumor size of thyroid cancers showed decreasing trends over time (p<0.01, respectively).
Highlights
From 2009 to 2014, thyroid cancer was the most common cancer in South Korea
Korea had the highest incidence of thyroid cancer worldwide, according to GLOBOCAN 2012 (Figure 1), and the incidence of thyroid cancer has increased rapidly since 1999 [1,2]
The incidence of thyroid cancer has been increasing worldwide, the unprecedented rapid increase of thyroid cancer in Korea is rare in any country
Summary
From 2009 to 2014, thyroid cancer was the most common cancer in South Korea (hereafter Korea). In the NEST data, the age-standardized prevalence of chronic lymphocytic thyroiditis among thyroid cancer patients increased from 1999 to 2008 This finding suggests that in more recent years, the incidence of thyroid cancer was associated with factors related to autoimmune thyroid diseases or more detailed pathological examination. Another study estimated the difference in age-standardized incidence rates between 1999 and 2008 according to the route of tumor detection (screening detection vs clinical detection) [7] These results showed that the increase in the incidence of thyroid cancer in Korea was mainly due to over-detection resulting from the widespread utilization of sensitive imaging tools such as ultrasonography. The strength of the NEST cohort is that first, it represents the entirety of patients with thyroid cancer in Korea It includes multiple variables, such as tumor size (mm), information on tumor stage, and method of treatment, that are not in the KCCR database. Regional comparisons have included evaluations of the impact of clinical evidence or guidelines, as well as health care policies
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